no scale on the detour map, but unless those blue bits are puddles, it looks like one hell of a detour. is thing going to screw up your getting to portland?

(ok, yeah, so there are bigger problems in the world, but....)

Yeah... I imagine it will slow down the trip down for orientation, but I'm especially not looking forward to sitting in traffic in a Uhaul.

The "last detour" was what I'd imagined would be the detour. The other detours are a little odd... you'll notice on that map there's a road 536 (aka Division St) on the left that is a hell of a lot shorter. I guess they're expecting traffic to be backed up pretty bad through the whole city...

Anyway, I'm glad no one was hurt. That seems kind of miraculous, even if the river was only 18 feet deep._________________"Worse comes to worst, my people come first, but my tribe lives on every country on earth. I値l do anything to protect them from hurt, the human race is what I serve." - Baba Brinkman

Interviews with residents from Reuters.
Although the narrator seriously can't pronounce Husby haha._________________A cigarette is the perfect type of a perfect pleasure. It is exquisite, and it leaves one unsatisfied. What more can one want? ~Oscar Wilde, The Picture of Dorian Gray

Huh. The National Institute of Mental Health is moving away from the DSM in terms of the research it funds in order to search out better diagnostic tools that aren't symptom-based.

That's great news for patients ten years from now, when we've collected enough data to hopefully begin to attach clinical significance to biological markers. It's been suggested for decades that, for instance, schizophrenia symptoms like hallucinations, delusions, flat affect, and paranoia may be caused by different structural abnormalities that present similar clinical symptoms (that is, having structure/system A be a little unusual may cause hallucinations and flat affect, and having structure/system B be a little unusual may cause flat affect and paranoia, etc).

It's gonna suck to be a researcher for a little bit, though, because it's cheaper to focus on patients who meet a diagnostic criteria than it is to test everyone with a particular symptom._________________"Worse comes to worst, my people come first, but my tribe lives on every country on earth. I値l do anything to protect them from hurt, the human race is what I serve." - Baba Brinkman

well, as a researcher, you never get to test _everyone_ - you get to test the people who meet your criteria and actually agree to participate in your study. and you can set your total N to whatever you need to satisfy your power analysis criteria. admittedly, it sounds like they want expensive stuff - genetic analysis and imaging to detect brain circuits - which is going to make getting enough patients to get meaningful data while staying within budget something of a challenge.

it sounds like the research could be pretty exciting, though - what if some of the symptoms have a common cause across what we now see as different diagnoses? or, as you say, we are able to subdivide people we now see has having a single diagnosis (like schizophrenia) into groups with different underlying causes, which may be amenable to different treatments? it could result in the sort of breakthroughs that have happened in cancer research, once people started understanding things like hormone sensitivities (i wonder how frustrating it must have been to treat breast cancer, for example, before they knew about things like HER2 - it must have been incredibly frustrating, treating two patients the same way and curing one but not the other - not understanding that the disease itself was different.)_________________aka: neverscared!

Joined: 09 Jul 2006Posts: 9702Location: I have to be somewhere? ::runs around frantically::

Posted: Fri May 31, 2013 1:30 am Post subject:

Oh that is just so awesome! This is going to be great!

The end result could totally be blood test deciding the best doses! Yes! Or other awesome things could happen! Eeeee!_________________Before God created Las he pondered on all the aspects a woman might have, he considered which ones would look good super-inflated and which ones to leave alone.
After much deliberation he gave her a giant comfort zone. - Michael

Yeah, part of the problem with treating symptoms the way we do is that we know things like schizophrenia are only partially treated by current therapies. People with schizophrenia may have "positive" and/or "negative" symptoms. Positive symptoms are additions to normal human experience, like hallucinations, and negative symptoms are subtractions, like a flat affect (lack of emotion). We can treat positive symptoms (by targeting dopamine systems in the brain stem, for instance), but not negative symptoms... and we know that changes in affect are related to "hypofrontality" - reduced activity in the frontal lobe (where your executive functions are). Are the changes in the dopaminergic pathways of the brainstem and the frontal cortex related? If so, why don't we see them together always? If not... how come we don't see hypofrontality or hallucinations more often alone? People who have mild positive symptoms often also have few or no negative symptoms.

I think your analogy is apt, in that eventually we'll have gene markers that coincide with the root biology of mental illnesses... I'm interested to find out just how many genes we start coming up with for all these disorders with biological bases. And then whether any of them can be treated more efficiently (they can hardly be treated less efficiently)._________________"Worse comes to worst, my people come first, but my tribe lives on every country on earth. I値l do anything to protect them from hurt, the human race is what I serve." - Baba Brinkman

has much work been done on genes and mental diseases? totally not my area. and with cancer, it's not just the "big" genes, like BRCA1&2 - it's all sorts of biochemical stuff that seem to differ. (sadly, my biochemistry and cell biology knowledge is so old all the stuff they talk about now tends to lose me rather thoroughly, so i don't even have the right words, let alone a coherent description - but i know there are lots of subtleties that are coming out now in how cancer actually "works".)

i get the sense that a lot of the medication for mental illnesses is now pretty much at the level of cancer treatment a couple of decades ago, which was essentially "KILL IT!!! KILL IT WITH A STICK!! KILLKILLKILL!"; now that we have a better sense of what actually works on specific things, in many cases the cancer can be treated without bringing the entire patient quite so near death.

ok, that's maybe not a great analogy with mental illnesses, but hopefully you get what i mean._________________aka: neverscared!

Joined: 09 Jul 2006Posts: 9702Location: I have to be somewhere? ::runs around frantically::

Posted: Fri May 31, 2013 1:51 am Post subject:

Oh yes because fun things like hallucinations, auditory and visual, happen with things that are not schizophrenia (hi! My, and my mom's, bipolar has distinct auditory hallucinations - not super typical! One of those symptoms you throw out because of overwhelming other symptoms). Fun!_________________Before God created Las he pondered on all the aspects a woman might have, he considered which ones would look good super-inflated and which ones to leave alone.
After much deliberation he gave her a giant comfort zone. - Michael

Right, and then you have things like schizoaffective disorder, which is kind of like schizophrenia and bipolar crossed... it's really been a "best fit" model, which just doesn't work. It's the best we have at the moment, but it really is anachronistic compared to the rest of medicine.

mouse wrote:

has much work been done on genes and mental diseases?

There's a lot of research into certain disorders - certainly bipolar and schizophrenia are at the top of that list (they are perhaps the most costly in terms of health care dollars, with the exception of depression) - but not much into others. Imaging, such as fMRI, has become hugely important in the study of all sorts of brain functions (disordered or otherwise), but gene studies for most mental illnesses are much fewer and farther between._________________"Worse comes to worst, my people come first, but my tribe lives on every country on earth. I値l do anything to protect them from hurt, the human race is what I serve." - Baba Brinkman

So how do you guys think the Human Rain Project is going to affect diagnosis and all that? I don't know very much about it, and I figure at least some of the enthusiasm I've heard about it has to be hyoe._________________[Stripeypants has enabled lurk mode.]

Did you mean the Human Brain Project in Europe? I think it's phenomenal. We have a lot of institutions that are devoted to brain science right now, such as the Allen Institute for Brain Science here in the US. Being able to model the human brain will take years, if not a decade or more, to become functional, but will eventually allow for the testing of therapies in the model prior to human testing which should cut down on R&D expenses and allow for researchers to drill down to the neuronal and gene level to attempt to better understand what causes mental illness, not to mention testing ideas that would never be possible in living brains.

In theory all of these efforts will be synergistic. The NIMH change will spur research that the Human Brain Project can incorporate into its model to better represent changes that lead to mental illness._________________"Worse comes to worst, my people come first, but my tribe lives on every country on earth. I値l do anything to protect them from hurt, the human race is what I serve." - Baba Brinkman